| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $90.00 | $90.00 | $630.00 | |
Medica
| Professional | $204.00 | $258.39 | $258.39 | |
Midlands
| Facility | $77.00 | $77.00 | $77.00 | |
Midlands
| Professional | $49.78 | $70.00 | $70.00 | |
Sanford Health Plan
| Professional | $55.50 | $61.70 | $80.81 |